|
RANGER GLOBAL DCB OTW4*120*150
|
Facility
|
IP
|
$8,091.75
|
|
|
Service Code
|
HCPCS C2623
|
| Hospital Charge Code |
27000276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,427.53 |
| Max. Negotiated Rate |
$7,768.08 |
| Rate for Payer: Aetna Commercial |
$6,230.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,311.56
|
| Rate for Payer: Cash Price |
$4,045.88
|
| Rate for Payer: Cigna Commercial |
$6,716.15
|
| Rate for Payer: First Health Commercial |
$7,687.16
|
| Rate for Payer: Humana Commercial |
$6,877.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,635.23
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,971.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,427.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,120.74
|
| Rate for Payer: Ohio Health Group HMO |
$6,068.81
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,473.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,039.82
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,583.31
|
| Rate for Payer: PHCS Commercial |
$7,768.08
|
| Rate for Payer: United Healthcare All Payer |
$7,120.74
|
|
|
RANGER GLOBAL DCB OTW4*150*150
|
Facility
|
IP
|
$9,752.50
|
|
|
Service Code
|
HCPCS C2623
|
| Hospital Charge Code |
27000276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,925.75 |
| Max. Negotiated Rate |
$9,362.40 |
| Rate for Payer: Aetna Commercial |
$7,509.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,606.95
|
| Rate for Payer: Cash Price |
$4,876.25
|
| Rate for Payer: Cigna Commercial |
$8,094.57
|
| Rate for Payer: First Health Commercial |
$9,264.88
|
| Rate for Payer: Humana Commercial |
$8,289.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,997.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,197.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,925.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,582.20
|
| Rate for Payer: Ohio Health Group HMO |
$7,314.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,802.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,484.67
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,729.23
|
| Rate for Payer: PHCS Commercial |
$9,362.40
|
| Rate for Payer: United Healthcare All Payer |
$8,582.20
|
|
|
RANGER GLOBAL DCB OTW4*150*150
|
Facility
|
OP
|
$9,752.50
|
|
|
Service Code
|
HCPCS C2623
|
| Hospital Charge Code |
27000276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,925.75 |
| Max. Negotiated Rate |
$9,362.40 |
| Rate for Payer: Aetna Commercial |
$7,509.43
|
| Rate for Payer: Anthem Medicaid |
$3,353.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,606.95
|
| Rate for Payer: Cash Price |
$4,876.25
|
| Rate for Payer: Cigna Commercial |
$8,094.57
|
| Rate for Payer: First Health Commercial |
$9,264.88
|
| Rate for Payer: Humana Commercial |
$8,289.62
|
| Rate for Payer: Humana KY Medicaid |
$3,353.88
|
| Rate for Payer: Kentucky WC Medicaid |
$3,388.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,997.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,197.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,925.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,421.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,582.20
|
| Rate for Payer: Ohio Health Group HMO |
$7,314.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,802.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,484.67
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,729.23
|
| Rate for Payer: PHCS Commercial |
$9,362.40
|
| Rate for Payer: United Healthcare All Payer |
$8,582.20
|
|
|
RANGER GLOBAL DCB OTW 4*150*90
|
Facility
|
IP
|
$8,821.75
|
|
|
Service Code
|
HCPCS C2623
|
| Hospital Charge Code |
27000276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,646.53 |
| Max. Negotiated Rate |
$8,468.88 |
| Rate for Payer: Aetna Commercial |
$6,792.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,880.97
|
| Rate for Payer: Cash Price |
$4,410.88
|
| Rate for Payer: Cigna Commercial |
$7,322.05
|
| Rate for Payer: First Health Commercial |
$8,380.66
|
| Rate for Payer: Humana Commercial |
$7,498.49
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,233.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,510.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,646.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,763.14
|
| Rate for Payer: Ohio Health Group HMO |
$6,616.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,057.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,674.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,087.01
|
| Rate for Payer: PHCS Commercial |
$8,468.88
|
| Rate for Payer: United Healthcare All Payer |
$7,763.14
|
|
|
RANGER GLOBAL DCB OTW 4*150*90
|
Facility
|
OP
|
$8,821.75
|
|
|
Service Code
|
HCPCS C2623
|
| Hospital Charge Code |
27000276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,646.53 |
| Max. Negotiated Rate |
$8,468.88 |
| Rate for Payer: Aetna Commercial |
$6,792.75
|
| Rate for Payer: Anthem Medicaid |
$3,033.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,880.97
|
| Rate for Payer: Cash Price |
$4,410.88
|
| Rate for Payer: Cigna Commercial |
$7,322.05
|
| Rate for Payer: First Health Commercial |
$8,380.66
|
| Rate for Payer: Humana Commercial |
$7,498.49
|
| Rate for Payer: Humana KY Medicaid |
$3,033.80
|
| Rate for Payer: Kentucky WC Medicaid |
$3,064.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,233.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,510.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,646.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,094.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,763.14
|
| Rate for Payer: Ohio Health Group HMO |
$6,616.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,057.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,674.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,087.01
|
| Rate for Payer: PHCS Commercial |
$8,468.88
|
| Rate for Payer: United Healthcare All Payer |
$7,763.14
|
|
|
RANGER GLOBAL DCB OTW 4*200*90
|
Facility
|
OP
|
$10,281.75
|
|
|
Service Code
|
HCPCS C2623
|
| Hospital Charge Code |
27000276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,084.53 |
| Max. Negotiated Rate |
$9,870.48 |
| Rate for Payer: Aetna Commercial |
$7,916.95
|
| Rate for Payer: Anthem Medicaid |
$3,535.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,019.77
|
| Rate for Payer: Cash Price |
$5,140.88
|
| Rate for Payer: Cigna Commercial |
$8,533.85
|
| Rate for Payer: First Health Commercial |
$9,767.66
|
| Rate for Payer: Humana Commercial |
$8,739.49
|
| Rate for Payer: Humana KY Medicaid |
$3,535.89
|
| Rate for Payer: Kentucky WC Medicaid |
$3,571.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,431.03
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,587.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,084.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,606.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,047.94
|
| Rate for Payer: Ohio Health Group HMO |
$7,711.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$8,225.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,945.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,094.41
|
| Rate for Payer: PHCS Commercial |
$9,870.48
|
| Rate for Payer: United Healthcare All Payer |
$9,047.94
|
|
|
RANGER GLOBAL DCB OTW 4*200*90
|
Facility
|
IP
|
$10,281.75
|
|
|
Service Code
|
HCPCS C2623
|
| Hospital Charge Code |
27000276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,084.53 |
| Max. Negotiated Rate |
$9,870.48 |
| Rate for Payer: Aetna Commercial |
$7,916.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,019.77
|
| Rate for Payer: Cash Price |
$5,140.88
|
| Rate for Payer: Cigna Commercial |
$8,533.85
|
| Rate for Payer: First Health Commercial |
$9,767.66
|
| Rate for Payer: Humana Commercial |
$8,739.49
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,431.03
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,587.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,084.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,047.94
|
| Rate for Payer: Ohio Health Group HMO |
$7,711.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$8,225.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,945.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,094.41
|
| Rate for Payer: PHCS Commercial |
$9,870.48
|
| Rate for Payer: United Healthcare All Payer |
$9,047.94
|
|
|
RANGER GLOBAL DCB OTW 4*40*135
|
Facility
|
OP
|
$7,726.75
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,318.03 |
| Max. Negotiated Rate |
$7,417.68 |
| Rate for Payer: Aetna Commercial |
$5,949.60
|
| Rate for Payer: Anthem Medicaid |
$2,657.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,026.86
|
| Rate for Payer: Cash Price |
$3,863.38
|
| Rate for Payer: Cigna Commercial |
$6,413.20
|
| Rate for Payer: First Health Commercial |
$7,340.41
|
| Rate for Payer: Humana Commercial |
$6,567.74
|
| Rate for Payer: Humana KY Medicaid |
$2,657.23
|
| Rate for Payer: Kentucky WC Medicaid |
$2,684.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,335.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,702.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,318.03
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,710.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,799.54
|
| Rate for Payer: Ohio Health Group HMO |
$5,795.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,181.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,722.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,331.46
|
| Rate for Payer: PHCS Commercial |
$7,417.68
|
| Rate for Payer: United Healthcare All Payer |
$6,799.54
|
|
|
RANGER GLOBAL DCB OTW 4*40*135
|
Facility
|
IP
|
$7,726.75
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,318.03 |
| Max. Negotiated Rate |
$7,417.68 |
| Rate for Payer: Aetna Commercial |
$5,949.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,026.86
|
| Rate for Payer: Cash Price |
$3,863.38
|
| Rate for Payer: Cigna Commercial |
$6,413.20
|
| Rate for Payer: First Health Commercial |
$7,340.41
|
| Rate for Payer: Humana Commercial |
$6,567.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,335.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,702.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,318.03
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,799.54
|
| Rate for Payer: Ohio Health Group HMO |
$5,795.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,181.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,722.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,331.46
|
| Rate for Payer: PHCS Commercial |
$7,417.68
|
| Rate for Payer: United Healthcare All Payer |
$6,799.54
|
|
|
RANGER GLOBAL DCB OTW 4*40*80
|
Facility
|
IP
|
$7,726.75
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,318.03 |
| Max. Negotiated Rate |
$7,417.68 |
| Rate for Payer: Aetna Commercial |
$5,949.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,026.86
|
| Rate for Payer: Cash Price |
$3,863.38
|
| Rate for Payer: Cigna Commercial |
$6,413.20
|
| Rate for Payer: First Health Commercial |
$7,340.41
|
| Rate for Payer: Humana Commercial |
$6,567.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,335.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,702.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,318.03
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,799.54
|
| Rate for Payer: Ohio Health Group HMO |
$5,795.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,181.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,722.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,331.46
|
| Rate for Payer: PHCS Commercial |
$7,417.68
|
| Rate for Payer: United Healthcare All Payer |
$6,799.54
|
|
|
RANGER GLOBAL DCB OTW 4*40*80
|
Facility
|
OP
|
$7,726.75
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,318.03 |
| Max. Negotiated Rate |
$7,417.68 |
| Rate for Payer: Aetna Commercial |
$5,949.60
|
| Rate for Payer: Anthem Medicaid |
$2,657.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,026.86
|
| Rate for Payer: Cash Price |
$3,863.38
|
| Rate for Payer: Cigna Commercial |
$6,413.20
|
| Rate for Payer: First Health Commercial |
$7,340.41
|
| Rate for Payer: Humana Commercial |
$6,567.74
|
| Rate for Payer: Humana KY Medicaid |
$2,657.23
|
| Rate for Payer: Kentucky WC Medicaid |
$2,684.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,335.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,702.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,318.03
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,710.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,799.54
|
| Rate for Payer: Ohio Health Group HMO |
$5,795.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,181.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,722.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,331.46
|
| Rate for Payer: PHCS Commercial |
$7,417.68
|
| Rate for Payer: United Healthcare All Payer |
$6,799.54
|
|
|
RANGER GLOBAL DCB OTW 4*60*80
|
Facility
|
IP
|
$7,726.75
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,318.03 |
| Max. Negotiated Rate |
$7,417.68 |
| Rate for Payer: Aetna Commercial |
$5,949.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,026.86
|
| Rate for Payer: Cash Price |
$3,863.38
|
| Rate for Payer: Cigna Commercial |
$6,413.20
|
| Rate for Payer: First Health Commercial |
$7,340.41
|
| Rate for Payer: Humana Commercial |
$6,567.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,335.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,702.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,318.03
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,799.54
|
| Rate for Payer: Ohio Health Group HMO |
$5,795.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,181.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,722.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,331.46
|
| Rate for Payer: PHCS Commercial |
$7,417.68
|
| Rate for Payer: United Healthcare All Payer |
$6,799.54
|
|
|
RANGER GLOBAL DCB OTW 4*60*80
|
Facility
|
OP
|
$7,726.75
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,318.03 |
| Max. Negotiated Rate |
$7,417.68 |
| Rate for Payer: Aetna Commercial |
$5,949.60
|
| Rate for Payer: Anthem Medicaid |
$2,657.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,026.86
|
| Rate for Payer: Cash Price |
$3,863.38
|
| Rate for Payer: Cigna Commercial |
$6,413.20
|
| Rate for Payer: First Health Commercial |
$7,340.41
|
| Rate for Payer: Humana Commercial |
$6,567.74
|
| Rate for Payer: Humana KY Medicaid |
$2,657.23
|
| Rate for Payer: Kentucky WC Medicaid |
$2,684.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,335.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,702.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,318.03
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,710.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,799.54
|
| Rate for Payer: Ohio Health Group HMO |
$5,795.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,181.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,722.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,331.46
|
| Rate for Payer: PHCS Commercial |
$7,417.68
|
| Rate for Payer: United Healthcare All Payer |
$6,799.54
|
|
|
RANGER GLOBAL DCB OTW 4*80*135
|
Facility
|
IP
|
$7,726.75
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,318.03 |
| Max. Negotiated Rate |
$7,417.68 |
| Rate for Payer: Aetna Commercial |
$5,949.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,026.86
|
| Rate for Payer: Cash Price |
$3,863.38
|
| Rate for Payer: Cigna Commercial |
$6,413.20
|
| Rate for Payer: First Health Commercial |
$7,340.41
|
| Rate for Payer: Humana Commercial |
$6,567.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,335.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,702.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,318.03
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,799.54
|
| Rate for Payer: Ohio Health Group HMO |
$5,795.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,181.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,722.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,331.46
|
| Rate for Payer: PHCS Commercial |
$7,417.68
|
| Rate for Payer: United Healthcare All Payer |
$6,799.54
|
|
|
RANGER GLOBAL DCB OTW 4*80*135
|
Facility
|
OP
|
$7,726.75
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,318.03 |
| Max. Negotiated Rate |
$7,417.68 |
| Rate for Payer: Aetna Commercial |
$5,949.60
|
| Rate for Payer: Anthem Medicaid |
$2,657.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,026.86
|
| Rate for Payer: Cash Price |
$3,863.38
|
| Rate for Payer: Cigna Commercial |
$6,413.20
|
| Rate for Payer: First Health Commercial |
$7,340.41
|
| Rate for Payer: Humana Commercial |
$6,567.74
|
| Rate for Payer: Humana KY Medicaid |
$2,657.23
|
| Rate for Payer: Kentucky WC Medicaid |
$2,684.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,335.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,702.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,318.03
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,710.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,799.54
|
| Rate for Payer: Ohio Health Group HMO |
$5,795.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,181.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,722.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,331.46
|
| Rate for Payer: PHCS Commercial |
$7,417.68
|
| Rate for Payer: United Healthcare All Payer |
$6,799.54
|
|
|
RANGER GLOBAL DCB OTW 4*80*80
|
Facility
|
OP
|
$7,726.75
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,318.03 |
| Max. Negotiated Rate |
$7,417.68 |
| Rate for Payer: Aetna Commercial |
$5,949.60
|
| Rate for Payer: Anthem Medicaid |
$2,657.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,026.86
|
| Rate for Payer: Cash Price |
$3,863.38
|
| Rate for Payer: Cigna Commercial |
$6,413.20
|
| Rate for Payer: First Health Commercial |
$7,340.41
|
| Rate for Payer: Humana Commercial |
$6,567.74
|
| Rate for Payer: Humana KY Medicaid |
$2,657.23
|
| Rate for Payer: Kentucky WC Medicaid |
$2,684.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,335.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,702.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,318.03
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,710.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,799.54
|
| Rate for Payer: Ohio Health Group HMO |
$5,795.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,181.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,722.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,331.46
|
| Rate for Payer: PHCS Commercial |
$7,417.68
|
| Rate for Payer: United Healthcare All Payer |
$6,799.54
|
|
|
RANGER GLOBAL DCB OTW 4*80*80
|
Facility
|
IP
|
$7,726.75
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,318.03 |
| Max. Negotiated Rate |
$7,417.68 |
| Rate for Payer: Aetna Commercial |
$5,949.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,026.86
|
| Rate for Payer: Cash Price |
$3,863.38
|
| Rate for Payer: Cigna Commercial |
$6,413.20
|
| Rate for Payer: First Health Commercial |
$7,340.41
|
| Rate for Payer: Humana Commercial |
$6,567.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,335.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,702.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,318.03
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,799.54
|
| Rate for Payer: Ohio Health Group HMO |
$5,795.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,181.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,722.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,331.46
|
| Rate for Payer: PHCS Commercial |
$7,417.68
|
| Rate for Payer: United Healthcare All Payer |
$6,799.54
|
|
|
RANGER GLOBAL DCB OTW5*100*135
|
Facility
|
IP
|
$9,205.00
|
|
|
Service Code
|
HCPCS C2623
|
| Hospital Charge Code |
27000276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,761.50 |
| Max. Negotiated Rate |
$8,836.80 |
| Rate for Payer: Aetna Commercial |
$7,087.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,179.90
|
| Rate for Payer: Cash Price |
$4,602.50
|
| Rate for Payer: Cigna Commercial |
$7,640.15
|
| Rate for Payer: First Health Commercial |
$8,744.75
|
| Rate for Payer: Humana Commercial |
$7,824.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,548.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,793.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,761.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,100.40
|
| Rate for Payer: Ohio Health Group HMO |
$6,903.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,364.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,008.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,351.45
|
| Rate for Payer: PHCS Commercial |
$8,836.80
|
| Rate for Payer: United Healthcare All Payer |
$8,100.40
|
|
|
RANGER GLOBAL DCB OTW5*100*135
|
Facility
|
OP
|
$9,205.00
|
|
|
Service Code
|
HCPCS C2623
|
| Hospital Charge Code |
27000276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,761.50 |
| Max. Negotiated Rate |
$8,836.80 |
| Rate for Payer: Aetna Commercial |
$7,087.85
|
| Rate for Payer: Anthem Medicaid |
$3,165.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,179.90
|
| Rate for Payer: Cash Price |
$4,602.50
|
| Rate for Payer: Cigna Commercial |
$7,640.15
|
| Rate for Payer: First Health Commercial |
$8,744.75
|
| Rate for Payer: Humana Commercial |
$7,824.25
|
| Rate for Payer: Humana KY Medicaid |
$3,165.60
|
| Rate for Payer: Kentucky WC Medicaid |
$3,197.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,548.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,793.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,761.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,229.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,100.40
|
| Rate for Payer: Ohio Health Group HMO |
$6,903.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,364.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,008.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,351.45
|
| Rate for Payer: PHCS Commercial |
$8,836.80
|
| Rate for Payer: United Healthcare All Payer |
$8,100.40
|
|
|
RANGER GLOBAL DCB OTW 5*100*80
|
Facility
|
OP
|
$7,726.75
|
|
|
Service Code
|
HCPCS C2623
|
| Hospital Charge Code |
27000276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,318.03 |
| Max. Negotiated Rate |
$7,417.68 |
| Rate for Payer: Aetna Commercial |
$5,949.60
|
| Rate for Payer: Anthem Medicaid |
$2,657.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,026.86
|
| Rate for Payer: Cash Price |
$3,863.38
|
| Rate for Payer: Cigna Commercial |
$6,413.20
|
| Rate for Payer: First Health Commercial |
$7,340.41
|
| Rate for Payer: Humana Commercial |
$6,567.74
|
| Rate for Payer: Humana KY Medicaid |
$2,657.23
|
| Rate for Payer: Kentucky WC Medicaid |
$2,684.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,335.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,702.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,318.03
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,710.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,799.54
|
| Rate for Payer: Ohio Health Group HMO |
$5,795.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,181.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,722.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,331.46
|
| Rate for Payer: PHCS Commercial |
$7,417.68
|
| Rate for Payer: United Healthcare All Payer |
$6,799.54
|
|
|
RANGER GLOBAL DCB OTW 5*100*80
|
Facility
|
IP
|
$7,726.75
|
|
|
Service Code
|
HCPCS C2623
|
| Hospital Charge Code |
27000276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,318.03 |
| Max. Negotiated Rate |
$7,417.68 |
| Rate for Payer: Aetna Commercial |
$5,949.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,026.86
|
| Rate for Payer: Cash Price |
$3,863.38
|
| Rate for Payer: Cigna Commercial |
$6,413.20
|
| Rate for Payer: First Health Commercial |
$7,340.41
|
| Rate for Payer: Humana Commercial |
$6,567.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,335.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,702.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,318.03
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,799.54
|
| Rate for Payer: Ohio Health Group HMO |
$5,795.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,181.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,722.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,331.46
|
| Rate for Payer: PHCS Commercial |
$7,417.68
|
| Rate for Payer: United Healthcare All Payer |
$6,799.54
|
|
|
RANGER GLOBAL DCB OTW5*120*150
|
Facility
|
OP
|
$9,551.75
|
|
|
Service Code
|
HCPCS C2623
|
| Hospital Charge Code |
27000276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,865.53 |
| Max. Negotiated Rate |
$9,169.68 |
| Rate for Payer: Aetna Commercial |
$7,354.85
|
| Rate for Payer: Anthem Medicaid |
$3,284.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,450.36
|
| Rate for Payer: Cash Price |
$4,775.88
|
| Rate for Payer: Cigna Commercial |
$7,927.95
|
| Rate for Payer: First Health Commercial |
$9,074.16
|
| Rate for Payer: Humana Commercial |
$8,118.99
|
| Rate for Payer: Humana KY Medicaid |
$3,284.85
|
| Rate for Payer: Kentucky WC Medicaid |
$3,318.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,832.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,049.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,865.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,350.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,405.54
|
| Rate for Payer: Ohio Health Group HMO |
$7,163.81
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,641.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,310.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,590.71
|
| Rate for Payer: PHCS Commercial |
$9,169.68
|
| Rate for Payer: United Healthcare All Payer |
$8,405.54
|
|
|
RANGER GLOBAL DCB OTW5*120*150
|
Facility
|
IP
|
$9,551.75
|
|
|
Service Code
|
HCPCS C2623
|
| Hospital Charge Code |
27000276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,865.53 |
| Max. Negotiated Rate |
$9,169.68 |
| Rate for Payer: Aetna Commercial |
$7,354.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,450.36
|
| Rate for Payer: Cash Price |
$4,775.88
|
| Rate for Payer: Cigna Commercial |
$7,927.95
|
| Rate for Payer: First Health Commercial |
$9,074.16
|
| Rate for Payer: Humana Commercial |
$8,118.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,832.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,049.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,865.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,405.54
|
| Rate for Payer: Ohio Health Group HMO |
$7,163.81
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,641.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,310.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,590.71
|
| Rate for Payer: PHCS Commercial |
$9,169.68
|
| Rate for Payer: United Healthcare All Payer |
$8,405.54
|
|
|
RANGER GLOBAL DCB OTW5*150*150
|
Facility
|
IP
|
$9,752.50
|
|
|
Service Code
|
HCPCS C2623
|
| Hospital Charge Code |
27000276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,925.75 |
| Max. Negotiated Rate |
$9,362.40 |
| Rate for Payer: Aetna Commercial |
$7,509.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,606.95
|
| Rate for Payer: Cash Price |
$4,876.25
|
| Rate for Payer: Cigna Commercial |
$8,094.57
|
| Rate for Payer: First Health Commercial |
$9,264.88
|
| Rate for Payer: Humana Commercial |
$8,289.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,997.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,197.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,925.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,582.20
|
| Rate for Payer: Ohio Health Group HMO |
$7,314.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,802.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,484.67
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,729.23
|
| Rate for Payer: PHCS Commercial |
$9,362.40
|
| Rate for Payer: United Healthcare All Payer |
$8,582.20
|
|
|
RANGER GLOBAL DCB OTW5*150*150
|
Facility
|
OP
|
$9,752.50
|
|
|
Service Code
|
HCPCS C2623
|
| Hospital Charge Code |
27000276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,925.75 |
| Max. Negotiated Rate |
$9,362.40 |
| Rate for Payer: Aetna Commercial |
$7,509.43
|
| Rate for Payer: Anthem Medicaid |
$3,353.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,606.95
|
| Rate for Payer: Cash Price |
$4,876.25
|
| Rate for Payer: Cigna Commercial |
$8,094.57
|
| Rate for Payer: First Health Commercial |
$9,264.88
|
| Rate for Payer: Humana Commercial |
$8,289.62
|
| Rate for Payer: Humana KY Medicaid |
$3,353.88
|
| Rate for Payer: Kentucky WC Medicaid |
$3,388.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,997.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,197.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,925.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,421.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,582.20
|
| Rate for Payer: Ohio Health Group HMO |
$7,314.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,802.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,484.67
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,729.23
|
| Rate for Payer: PHCS Commercial |
$9,362.40
|
| Rate for Payer: United Healthcare All Payer |
$8,582.20
|
|
